HomeMy WebLinkAboutContract 58790CSC No. 58790
FORT WORTH
CITY OF FORT WORTH
COOPERATIVE PURCHASE AGREEMENT
This Cooperative Purchase Agreement ("Agreement") is entered into by and between MoboTrex, Inc
("Vendor") and the City of Fort Worth, ("City"), a Texas home rule municipality.
The Cooperative Purchase Agreement includes the following documents which shall be construed in the order of
precedence in which they are listed:
This Cooperative Purchase Agreement;
Exhibit A — Seller's Quote, Scope of Services or Purchase Order;
Exhibit B — Cooperative Agency Contract BuyBoard 608-20; and
Exhibit C — Conflict of Interest Questionnaire
Exhibits A, B, and C, which are attached hereto and incorporated herein, are made a part of this Agreement
for all purposes. Vendor agrees to provide City with the services and goods included in Exhibit A pursuant to the
terms and conditions of this Cooperative Purchase Agreement, including all exhibits thereto.
City shall pay Vendor in accordance with the fee schedule in Exhibit A and in accordance with the
provisions of this Agreement. Total payment made under this Agreement for the first year by City shall not exceed
Two hundred and fifty thousand dollars ($250,000.00). Vendor shall not provide any additional items or
services or bill for expenses incurred for City not specified by this Agreement unless City requests and approves
in writing the additional costs for such services. City shall not be liable for any additional expenses of Vendor not
specified by this Agreement unless City first approves such expenses in writing.
OFFICIAL RECORD
The term of this Agreement is effective beginning on the date signed by the Assistant City CITY SECRETARY
Manager below ("Effective Date") and expires on May 31, 2023 with no options to renew. FT. WORTH, Tx
Vendor agrees that City shall, until the expiration of three (3) years after final payment under this
Agreement, or the final conclusion of any audit commenced during the said three years, have access to and the
right to examine at reasonable times any directly pertinent books, documents, papers and records, including, but
not limited to, all electronic records, of Vendor involving transactions relating to this Agreement at no additional
cost to City. Vendor agrees that City shall have access during normal working hours to all necessary Vendor
facilities and shall be provided adequate and appropriate work space in order to conduct audits in compliance with
the provisions of this section. City shall give Vendor reasonable advance notice of intended audits.
Vendor agrees to comply with all federal statutes relating to nondiscrimination, labor standards, domestic
preference and environmental compliance. Additionally, for work to be performed under the Agreement or
subcontract thereof, including procurement of materials or leases of equipment, Vendor shall notify each potential
subcontractor or supplier of the Vendor's federal compliance obligations. These may include, but are not limited
to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race,
color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§ 1681-
1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) the Fair Labor Standards Act of
1938 (29 USC 676 et. seq.), (d) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. § 794),
which prohibits discrimination on the basis of handicaps and the Americans with Disabilities Act of 1990; (e) the
Age Discrimination in Employment Act of 1967 (29 USC 621 et. seq.) and the Age Discrimination Act of 1974,
as amended (42 U.S.C. §§ 6101-6107), which prohibits discrimination on the basis of age; (f) any other
nondiscrimination provisions in any specific statute(s) applicable to any Federal funding for this Agreement; (g)
the requirements of any other nondiscrimination statute(s) which may apply to this Agreement; (h) applicable
provisions of the Davis -Bacon Act under 40 USC § 3141 — 3148, and the Contract Work Hours and Safety
Standards Act under 40 USC § 3701 — 3708; (i) applicable provisions of the Rights to Invention Made Under
Contract or Agreement Act under 37 CFR Part 401; 0) applicable provisions of the Clean Air Act under 42 USC
§ 7401 — 7671, the Energy Federal Water Pollution Control Act 33 USC § 1251 — 1387, and the Energy Policy
Conservation Act under 42 USC § 6201; (k) compliance with all Buy America requirements under 23 USC 313
and 23 CFR 635.410, which require a domestic manufacturing process for any steel or iron products; (1)
Compliance with Prohibition on Certain Telecommunications and Video Surveillance Services or Equipment
under 2 CFR §200.216 and §200.471; (m) compliance with federal assistance programs under Executive Order
12549, Debarment and Suspension, which prohibit participation of debarred or suspended or otherwise excluded
from or ineligible vendor or its suppliers using federal funds; (n) compliance with federal restriction on lobbying
expenditures under 2 CFR 200 clauses: (o) consistent with Domestic preferences for procurements under 2 CFR
§200.322, which provide a preference for the purchase, acquisition, or use of goods, products, or materials
produced in the United States as appropriate and to the greatest extent practicable.
Notices required pursuant to the provisions of this Agreement shall be conclusively determined to have
been delivered when (1) hand -delivered to the other party, its agents, employees, servants or representatives, (2)
delivered by facsimile with electronic confirmation of the transmission, or (3) received by the other party by
United States Mail, registered, return receipt requested, addressed as follows:
To CITY:
To VENDOR:
City of Fort Worth MoboTrex, Inc
Attn: William Johnson, Assistant City Manager Vincent Holdridge, Inside Sales Representative
200 Texas Street
Fort Worth, TX 76102-6314 Address:
Facsimile: (817) 392-8654 109 West 55th Street
Davenport, IA 52806
With copy to Fort Worth City Attorney's Office at
same address Facsimile: N/A
The undersigned represents and warrants that he or she has the power and authority to execute this Agreemen
and bind the respective Vendor.
CITY OF FORT WORTH:
William Johnson (Jar/30, 202315:35 CST)
Name: William Johnson
Title: Assistant City Manager
Date: ,tan 30, 2023
APPROVAL RECOMMENDED:
10
Lauren Prieur (Jan 27, 2023 13:49 CST)
Name: Lauren Prieur
Title: Interim Transportation & Public
Works Director
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ATTEST: �,°�E�Rto�d
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By:
Name: Jannette Goodall
Title: City Secretary
VENDOR:
MoboTrex, Inc
By:
Name: Vincent Holdridge
Title: Inside Sales Representative
Date: 01 /27/2023
CONTRACT COMPLIANCE MANAGER:
By signing I acknowledge that I am the person
responsible for the monitoring and administration
of this contract, including ensuring all performance
and reporting requirements.
an
Aziz Rah (Jan 27, 202313:43 CST)
Name: Aziz Rahman
Title: Engineering Manager
APPROVED AS TO FORM AND LEGALITY:
By:
Jessika Williams (Jan 30, 202310:02 CST)
Name: Jessika Williams
Title: Assistant City Attorney
CONTRACT AUTHORIZATION:
M&C: 23-0003
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
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7
m
Board® EXHIBIT B
Cooperative Purchasing
P.O. Sax 400
Austin, TX 78767-0400
800.695.2919 / 512.467.0222 / fax. 800.211.5454
huyhoard. cam
April 29, 2020
Sent Via Email: vholdridge@mobotrex.com
Vincent Holdridge
MoboTrex, Inc.
109 W. 55th Street
Davenport, IA 52806
Welcome to BuyBoard!
Re: Notice of The Local Government Purchasing Cooperative Award
Proposal Name and Number: Highway Safety and Traffic Control Products, Proposal No. 608-20
Congratulations, The Local Government Purchasing Cooperative (Cooperative) has awarded your company a BuyBoard®
contract based on the above -referenced Proposal. The contract is effective 6/1/2020 through 5/31/2021, with two possible
one-year renewals. The contract documents are those identified in Section 3 of the General Terms and Conditions of the
specifications.
To view the items your company has been awarded, please review the proposal tabulation No. 608-20 on the following
web -site: www.buyboard.com/vendor. Only items marked as awarded to your company can be sold through the BuyBoard
contract. In addition, on this website you will find the membership list which will provide you with the names of all entities
with membership in our purchasing cooperative.
Enclosed with this letter you will find the following documents:
1. Vendor Quick Reference Guide 2. BuyBoard License and Identity Standards
You are advised that receipt of a purchase order directly from a Cooperative member is not within the
guidelines of the Cooperative. Accepting purchase orders directly from Cooperative members may result in a violation
of the State of Texas competitive bid statute and termination of this Cooperative BuyBoard contract. Therefore, all
purchase orders must be processed through the BuyBoard in order to comply. Please forward by email to
info@buyboard.com any order received directly from a Cooperative member. If you inadvertently process a purchase
order sent directly to you by a Cooperative member, please email the order info@buyboard.com and note it as RECORD
ONLY to prevent duplication.
As an awarded vendor a BuyBoard user id and password will be sent via e-mail 2 to 3 business days prior to
the start of your contract.
On behalf of the Texas Association of School Boards, we appreciate your interest in the Cooperative and we are looking
forward to your participation in the program. If you have any questions, please contact Cooperative Procurement Staff
at 800-695-2919.
Arturo Salinas
Department Director, Cooperative Procurement
V.6.5
�+►— The Local Cc vernmentPurchasing Cooperative is endorsed by the Texas Association of School Boards,
® Tea Texas Municipal League, Texas Association of Counties, and the Texas Association of School Administrators.
National School
Endorsed by 'NSBA' Boards Association
April 29, 2020
Sent Via Email: vholdridge@mobotrex.com
Vincent Holdridge
MoboTrex, Inc.
109 W. 55th Street
Davenport, IA 52806
Welcome to BuyBoard!
Re: Notice of National Purchasing Cooperative Award
Proposal Name and Number: Highway Safety and Traffic Control Products, Proposal No. 608-20
Congratulations, The National Purchasing Cooperative (National Cooperative) has awarded your company a BuyBoard®
contract based on the above -referenced Proposal. As provided for in the Proposal and your National Purchasing
Cooperative Vendor Award Agreement, you are authorized to sell the goods and services awarded under the Proposal to
National Cooperative members in states other than Texas through the BuyBoard. The contract is effective 6/1/2020
through 5/31/2021, with two possible one-year renewals.
The National Cooperative membership list is available at our website www.buyboard.com/vendor. The list identifies the
current members that may purchase awarded goods and services under your National Cooperative BuyBoard contract.
You are advised that receipt of a purchase order directly from a National Cooperative member is not within
BuyBoard guidelines. Accepting purchase orders directly from Cooperative members may result in a violation of
applicable competitive procurement law and termination of this National Cooperative BuyBoard contract. Therefore, all
purchase orders from National Cooperative members must be processed through the BuyBoard. Please
forward by e-mail to info@buyboard.com any order received directly from a National Cooperative member. If you
inadvertently process a purchase order sent directly to you by a National Cooperative member, please fax the order to the
above number and note it as RECORD ONLY to prevent duplication.
As an awarded vendor a BuyBoard user id and password will be sent via e-mail 2 to 3 business
days prior to the start of your contract.
On behalf of the National Cooperative, we are looking forward to your participation in the program. If you have any
questions, please contact Cooperative Procurement Staff at 800-695-2919.
Arturo Salinas
Department Director, Cooperative Procurement
v.6.5
NA
P.O. Box 400, Austin, Texas 78767-0400
800,695.2919 • buyboard.com
DuBaar�l
Coup ura tive Puruhasfag
12007 Research Boulevard ' Austin, Texas 78759-2439 - PH: 800-695-2919 ' FAX: 800-211-5454 ' buvboard,corn
PROPO5ER's AGREEMENT AND SIGNATURE
Proposal Name: Highway Safety and Traffic
Control Products
Proposal Number: 608-20
Contract Time Period: June 1, 2020 through May
31, 2021 with two (2) possible: one-year renewals.
MoboTrex, Inc
Name of Proposing Company
109 W 55th ST
Street Address
Davenport, IA 52806
City, State, Zip
512-521-3337
Proposal Due Date/Oyenin4 Date and Time:
November 7, 2019 at 4:00 PM
Location of Proposal Opening:
Texas Association of School Boards, Inc.
BuyBoard Department
12007 Research Blvd.
Austin, TX 78759
Anticipated_ Coogerati►re_Board Meeting Date:
April 2020
11-5-2019
Date
Signature of Authoriz parry
Vincent Holdridge
Printed Name of Authorized Company Official
Inside Sales Rep
Telephone Number of Authorized Company Official Position or Title of Authorized Company Official
5633238256
36-2656899
Fax Number of Authorized Company Official Federal ID Number
Page 8 of 63
Proposal Forms COMMjSCS Y.05.3L2014
Wcoapwauve Purchasing
12007 Research Boulevard ' Austin, Texas 78759-2439 , PH! 800-695-2919 ' FAX: 800-211-5454 • buylagard,corn
The proposing company ["you" or "your") hereby acknowledges and agrees as follows:
1. You have carefully examined and understand all Cooperative information and documentation associated with this
Proposal Invitation, including the Instructions to Proposers, General Terms and Conditions, attachments/towns, item
specifications, and line items (collectively "Requirements';
2. By your response ("Proposal") to this Proposal Invitation, you propose to supply the products or services submitted at
the prices quoted in your Proposal and in strict compliance with the Requirements, unless specific deviations or
exceptions are noted In the Proposal;
3. Any and all deviations and exceptions to the Requirements have been noted in your Proposal and no others will be
claimed;
4. If the Cooperative accepts any part of your Proposal and awards you a contract, you will furnish all awarded products
or services at the prices quoted and in strict compliance with the Requirements (unless specific exceptions are noted in
the Proposal and accepted by the Cooperative), including without limitation the Requirements related to:
a. conducting business with Cooperative members, including offering pricing to members that is the best you offer
compared to similar customers;
b. payment of a service fee in the amount specified and as provided for in this Proposal Invitation;
c, the possible award of a piggy -back contract by another governmental entity or nonprofit entity, in which event
you will offer the awarded goods and services in accordance with the Requirements; and
d. submitting price sheets or catalogs in the proper format as required by the Cooperative as a prerequisite to
activation of your contract;
S. You have clearly identified on the included form any information in your Proposal that you believe to be confidential or
proprietary or that you do not consider to be public information subject to public disc;osure under a Texas Public
Information Act request or similar public information law;
6. The individual signing this Agreement is duly authorized to enter into the contractual relationship represented by this
Proposal Invitation on your behalf and bind you to the Requirements, and such individual (and any individual signing a
Form) is authorized and has the requisite knowledge to provide the information and make the representations and
certifications required in the Requirements;
7. You have carefully reviewed your Proposal, and certify that all information provided is true, complete and accurate, and
you authorize the Cooperative to take such action as it deems appropriate to verify such information; and
8. Any misstatement, falsification, or omission in your Proposal, whenever or however discovered, may disqualify you
from consideration for a contract award under this Proposal Invitation or result in termination of an award or any other
remedy or action provided for in the General Terms and Conditions or by law.
Page 9 of 63
Proposal Forms COMM/sVC5 v.05.31.201(t
Pa Board®
Cooperative Purchasing
12007 Research Boulevard * Austin, Texas 78759-2439 - PH: 800-695-2919 ' FAX: 800-211-5454 • buyboard.com
Name of Company:
VENDOR CONTACT INFORMATION
MoboTrex, Inc
Vendor Proposal/Contract Contact Name:
Vincent Holdridge
Vendor Proposal/Contract Contact E-mail Address:
vholdridge@mobotrex.com
Vendor Contact Mailing Address for Proposal/Contract Notices:
Company Website:
www.mobotrex.com
109 W 55th St, Davenport, IA 52806
Purchase Orders: All purchase orders from Cooperative members will be available through the Internet. Vendors need
Internet access and at least one e-mail address so that notification of new orders can be sent to the Internet contact when
a new purchase order arrives. An information guide will be provided to vendors to assist them with retrieving their orders.
Please select options below for receipt of purchase orders and provide the requested information:
F1 I will use the internet to receive purchase orders at the following address:
Purchase Order E-mail Address: vholdrldge@mobotrex.com
Purchase Order Contact: Vincent Holdridge
Phone: 512-521-3337
Alternate Purchase Order E-mail Address: CCOOper@mObOtreX.COm
Alternate Purchase Order Contact: Cameron Cooper Phone: 512-496-361 1
❑ Purchase orders may be received by the Designated Dealer(s) identified on my company's Dealer
Designation form as provided to the Cooperative administrator. I understand that my company shall
remain responsible for the Contract and the performance of all Designated Dealers under and in
accordance with the Contract.
Request for Ouotes ("RFO"): Cooperative members will send RFQs to you by e-mail. Please provide e-mail addresses
for the receipt of RFQs:
RFQ E-mail Address
RFQ Contact:
vholdridge@mobotrex.com
Vincent Holdridge
Alternate RFQ E-mail Address
Alternate RFQ Contact;
ccooper@mobotrex.com
Phone: 512-521-3337
Cameron Cooper Phone: 512-496-3611
Page 16 of 63
Proposal Forms COMM/S/CS v.05.31.2019
WCapperative Purchasing
12007 Research Boulevard • Austin, Texas 78759-2439 , PH: 800-695-2919 • FAX: 800-211-5454 • buvboard.com
Invoices: Your company will be billed monthly for the service fee due under a contract awarded under this Proposal
Invitation. All invoices are available on the BuyBoard website and e-mail notifications will be sent when they
are ready to be retrieved. Please provide the following address, contact and e-mail information for receipt of service Fee
Invoices and related communications:
Please choose onfY orml1) of the following options for receipt of invoices and provide the requested
information-
0 Service fee invoices and related communications should be provided directly to my company at:
Invoice Mailing address:
City: Davenport
109 W 55th ST
Contact Name; Eyd i e Petersen
state: I A
Department:
Zip Code: 52806
Phone: 563-328-4476
Invoice Fax: Invoice E-mail Address: ap@mobotrex.com
Alternative Invoice E-mail Address: vhoidridge@mobotrex.Com
In lieu of my company, I request and authorize all service fee invoices to be provided directly to the following billing
agent":
Billing agent Mailing address:
City:
Billing Agent Contact Name:
Billing Agent Fax:
State:
Billing Agent E-mail Address:
Alternative Billing Agent E-mail Address:
Department:
Zip Code:
Phone:
** If Vendor authorizes a bllling agent to receive and process service fee Involces, In accordance with the
General Terms and Condition of the Contract, Vendor speclflcally acknowledges and agrees that nothing In
that deslgnatlon shall relieve Vendor of Its responslbllltles and obllgatlons under the Contract Including, but
not Ilmlted to, payment of all service fees under any Contract awarded Vendor.
Page I I of 63
Proposal Farms COMM/5VC5 v.05.31.20I9
Pp Board®
Cooperative Purchasing
12007 Research Boulevard • Austin, Texas 78759-2439 - PH: 800-695-2919 . FAX: 800-211-5454 • buvboard.com
FELONY CONVICTION DISCLOSURE AND DEBARMENT CERTIFICATION
FELONY CONVICTION DISCLOSURE
Subsection (a) of Section 44.034 of the Texas Education Code (Notification of Criminal History of Contractor)
states: "A person or business entity that enters into a contract with a school district must give advance notice to the district
if the person or an owner or operator has been convicted of a felony. The notice must include a general description of the
conduct resulting in the conviction of a felony."
Section 44.034 further states in Subsection (b): "A school district may terminate a contract with a person or business
entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or
misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for
services performed before the termination of the contract."
Please check CV) one of the following:
0 My company is a publicly -held corporation. (Advance notice requirement does not apply to publicly -held corporation.)
❑ My company is not owned or operated by anyone who has been convicted of a felony.
❑ My company is owned/operated by the following individual(s) who has/have been convicted of a felony:
Name of Felon(s):
Details of Conviction(s):
By signature below, I certify that the above information is true, complete and accurate and that I am authorized by my
company to make this certification.
MoboTrex, Inc
•-1
a_
Signature of Authorized Company Official
Company Name
Vincent Holdridge
Printed Name
DEBARMENT CERTIFICATION
Neither my company nor an owner or principal of my company has been debarred, suspended or otherwise made ineligible
for participation in Federal Assistance programs under Executive Order 12549, "Debarment and Suspension," as described
in the Federal Register and Rules and Regulations. Neither my company nor an owner or principal of my company is
currently listed on the government -wide exclusions in SAM, debarred, suspended, or otherwise excluded by agencies or
declared ineligible under any statutory or regulatory authority. My company agrees to immediately notify the Cooperative
and all Cooperative members with pending purchases or seeking to purchase from my company if my company or an
owner or principal is later listed on the government -wide exclusions in SAM, or is debarred, suspended, or otherwise
excluded by agencies or declared ineligible under any statutory or regulatory authority.
By signature below, I certify that the above is true, complete and accurate and that I am authorized by my company to
make this certification.
MoboTrex, Inc
Company Name
Signature of Authorized Co fficial
Vincent Holdridge
Printed Name
Page 12 of 63
Proposal Forms COMM/SVCS v.05.31.2019
PFBoard
Couperative Purchasing
12007 Research Boulevard • Austin, Texas 78759-2439 - PH: 800-695-2919 • FAX: 800-211-5454 • ouyboaro.com
RESIDENT/ NONRESIDENT CERTIFICATION
Chapter 2252, Subchapter A, of the Texas Government Code establishes certain requirements applicable to proposers who
are not Texas residents. Under the statute, a "resident" proposer is a person whose principal place of business is in Texas,
including a contractor whose ultimate parent company or majority owner has its principal place of business in Texas. A
"nonresident" proposer is a person who is not a Texas resident. Please indicate the status of your company as a "resident"
proposer or a "nonresident" proposer under these definitions.
Please check N) one of the following:
❑ I certify that my company is a Resident Proposer.
I certify that my company is a Nonresident Proposer.
If your company is a Nonresident Proposer, you must provide the following information for your resident state (the state in
which your company's principal place of business is located):
MoboTrex, Inc
Company Name
Davenport
City
109 W 55th St
Address
IA
State
52806
Zip Code
A. Does your resident state require a proposer whose principal place of business is in Texas to under -price proposers
whose resident state is the same as yours by a prescribed amount or percentage to receive a comparable contract?
❑ Yes ❑ No
B. What is the prescribed amount or percentage? $ or %
VENDOR EMPLOYMENT CERTIFICATION
Section 44.031(b) of the Texas Education Code establishes certain criteria that a school district must consider when
determining to whom to award a contract. Among the criteria for certain contracts is whether the vendor or the vendor's
ultimate parent or majority owner (i) has its principal place of business in Texas; or (ii) employs at least 500 people in
Texas.
If neither your company nor the ultimate parent company or majority owner has its principal place of business in Texas,
does your company, ultimate parent company, or majority owner employ at least 500 people in Texas?
Please check N) one of the following:
❑ Yes ❑ No
By signature below, 1 certify that the Information in Sections 1 (RestdenVVNonres1dent Certification) and 2 (Vendor
Employment Certification) above is true, complete and accurate and that I am authorized by my company to make this
certification.
MoboTrex, Inc
Signature of Authorized Com icial
Company Name
Vincent Holdridge
Printed Name
Page 13 of 63
Proposal Forms COMM/SVCS v.05.31.2019
D a 0
Board
Cooperative Purchasing
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • FAX: 600-211-5454 • buyboard.com
NO ISRAEL BOYCOTT CERTIFICATION
Effective September 1, 2017, as amended effective May 7, 2019 (H.B. 793), a Texas governmental entity may not enter
into a contract with a value of $100,000 or more that is to be paid wholly or partly from public funds with a company
(excluding a sole proprietorship) that has 10 or more full-time employees for goods or services unless the contract contains
a written verification from the company that it: (1) does not boycott Israel; and (2) will not boycott Israel during the term
of the contract. (TEX. Gov`r CODE Ch. 2270). Accordingly, this certification form is included to the extent required by law.
"Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that is
intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or
entity doing business in Israel or in an Israeli -controlled territory, but does not include an action made for ordinary business
purposes. TEx. Gov`r CODE §808.001(1).
By signature below, I certify and verify that Vendor does not boycott Israel and will not boycott Israel during the term of
any contract awarded under this Proposal Invitation, that this certification is true, complete and accurate, and that I am
authorized by my company to make this certification.
MoboTrex, Inc
Company Name
Signature of Authorized Company Official
Vincent Holdridge
Printed Name
Note: If Vendor does not w/sh to make th/s certlftatlon, return the blank form /n lleu of a completed
cert/f/catlon.
NO EXCLUDED NATION OR FOREIGN TERRORIST ORGANIZATION CERTIFICATION
Effective September 1, 2017, Chapter 2252 of the Texas Government Code provides that a Texas governmental entity may
not enter into a contract with a company engaged in active business operations with Sudan, Iran, or a foreign terrorist
organization — specifically, any company identified on a list prepared and maintained by the Texas Comptroller under Texas
Government Code §§806.051, 807.051, or 2252.153. (A company that the U.S. Government affirmatively declares to be
excluded from its federal sanctions regime relating to Sudan, Iran, or any federal sanctions regime relating to a foreign
terrorist organization is not subject to the contract prohibition.)
By signature below, I certify and verify that Vendor is not on the Texas Comptroller's list identified above; that this
certification is true, complete and accurate; and that I am authorized by my company to make this certification.
MoboTrex, Inc
Signature of Authorized Company Official
Company Name
Vincent Holdridge
Printed Name
Page 14 of 63
Proposal Forms COMM/SVCS v.05.31.2019
P p 0
Board
Cooperative Pu►chasing
12007 Research Boulevard ' Austin, Texas 78759-2439 - PH: 800-695-2919 ' FAX: 800-211-5454 • buYboard.corn
HISTORICALLY UNOERUTILIZEO BUSINESS CERTIFICATION
A proposer that has been certified as a historically Underutilized Business (also known, as a Minority/Women Business
Enterprise or "MWBE" and all referred to in this Form as a "HUB'} is encouraged to indicate its HUB certification status
when responding to this Proposal Invitation. The electronic catalogs will indicate HUB certifications for vendors that
properly indicate and document their HUB certification on this form.
Please check (-V) all that apply:
❑ I certify that my company has been certified as a HUB in the following categories:
❑ Minority awned Business
❑ Women awned Business
❑ Service -Disabled Veteran Owned Business (veteran defined by 38 U.S.C. §101(2), who has a
service -connected disability as defined by 38 U.S.C. § 101(16), and who has a disability rating
of 20% or more as determined by the U. S. Department of Veterans Affairs or Department of
Defense]
Certification Number:
Name of Certifying Agency:
❑ My company has NOT been certified as a HUB.
By signature below, I Certify that the above is true, complete and accurate and that I am authorized by my
company to make this certification.
MoboTrex, Inc
Company Dame
Vincent Holdridge
Printed Name
Signature of Authorized Com lal
Page 15 of 63
Proposal Forms Comm/Svcs v.05.31.2019
A a 0
Board
Cooperative Purchasing
12007 Research Boulevard , Austin, Texas 78759-2439 - PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com
CONSTRUCTION- RELATED GOODS AND SERVICES AFFIRMATION
A contract awarded under this Proposal Invitation covers only the specific goods and services awarded by the BuyBoard. As
explained in the BuyBoard Procurement and Construction Related Goods and Services Advisory for Texas Members
("Advisory's, Texas law prohibits the procurement of architecture or engineering services through a
purchasing cooperative. This BuyBoard contract does not include such services. Architecture or engineering
services must be procured by a Cooperative member separately, in accordance with the Professional
Services Procurement Act (Chapter 2254 of the Texas Government Code) and other applicable law and local
policy.
The Advisory, available at buyboard.com/Vendor/Resources.aspx, provides an overview of certain legal requirements that
are potentially relevant to a Cooperative member's procurement of construction or construction -related goods and services,
including those for projects that may involve or require architecture, engineering or independent testing services. A copy
of the Advisory can also be provided upon request.
By signature below, the undersigned affirms that Proposer has obtained a copy of the Advisory, has read and understands
the Advisory, and is authorized by Proposer to make this affirmation. If Proposer sells construction -related goods or
services to a Cooperative member under a BuyBoard contract awarded under this Proposal Invitation, Proposer will comply
with the Advisory and applicable legal requirements, make a good faith effort to make its Cooperative member customers
or potential Cooperative member customers aware of such requirements, and provide a Cooperative member with a copy
of the Advisory before executing a Member Construction Contract with the member or accepting the member's purchase
order for construction -related goods or services, whichever comes first.
MoboTrex, Inc
Company Name
Signature of Authorized Company Official
Vincent Holdridge
Printed Name
11-5-2019
Date
Page 16 of 63
Proposal Forms COMM/SVCS v.05,31.2019
P p 0
Cooperative purchashig
12007 Research Boulevard • Austin, "texas 78759-2439 , PH: 800-595-2919 • FAX: 800-211-5454 • buyboard.com
DEVIATION AND COMPLIANCE
If your company intends to deviate from the General Terms and Conditions, Proposal Specifications or other requirements
associated with this Proposal Invitation, you MUST list all such deviations on this form, and provide complete and detailed
information regarding the deviations on this form or an attachment to this form. The Cooperative will consider any
deviations in its contract award decision, and reserves the right to accept or reject a proposal based upon any submitted
deviation,
In the absence of any deviation identified and described in accordance with the above, your company must Fully comply
with the General Terms and Conditions, Proposal Specifications and all other requirements associated with this Proposal
Invitation if awarded a contract under this Proposal Invitation. A deviation will not be effective unless accepted by the
Cooperative. The Cooperative may, in its sole discretion, seek clarification from and/or communicate with Proposer(s)
regarding any submitted deviation, consistent with general procurement principles of fair competition, The Cooperative
reserves the right to accept or reject a proposal based upon any submitted deviation.
Please check_( }_one_of_the following:
>!❑ NO; Deviations
❑ YeS; Deviations
List and fully explain any deviations you are submitting:
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: ■❑ Common Carrier ❑ Company Truck ❑ Prepaid and Add to Invoice ❑ Other:
2, Payment Terms: H Net 30 days ❑ 1% in 10/Net 36 days ❑ Other:
3. Number of Days for delivery: 45-60ARO
4. Vendor Reference/Quote Number:
5. State your return policy: Restocking tee of up to 20% may apply
6. Are electronic payments acceptable? ®Yes ❑ No
7. Are credit card payments acceptabie? ■❑Yes ❑ No
MoboTrex, Inc
Company Name
Signature of Authorized Company Official
Vincent Holdridge
Printed Name
Page 17 of 63
Proposal Forms COMM/WCS VM.31.2a19
Board
Cooperative Purchasing®
12007 Research Boulevard • Austin, Texas 78759-2439 , PH: 800-695-2919 • FAX: 800-211-5454 ' buvboard.com
LOCATION/AUTHORIZED SELLER LISTINGS
If you have more than one location/authorized seller that will service a contract awarded under this Proposal Invitation,
please list each location/authorized seller below. If additional sheets are required, please duplicate this form as necessary.
NOTE: Awarded Vendors shall remain responsible for all aspects of the Contract, including processing of Purchase Orders,
and shall be responsible for the performance of all locations and authorized sellers under and in accordance with the
Contract. If you are a product manufacturer and wish to designate Designated Dealers as defined in the General Terms
and Conditions to receive Cooperative member Purchase Orders on your behalf, you must complete the Manufacturer
Designated Dealer form.
MoboTrex, Inc
Company Name
301 W Howard Lane
Address
Austin
TX
78753
City State Zip
512-521-3337
Phone Number Fax Number
Vincent Holdridge
Contact Person
Company Name
Address
City State Zip
Phone Number Fax Number
Contact Person
Page 18 of 63
Proposal Forms COMM/SVCS v.05.31.2019
WBoard®
ooperative Purchasing
12007 Research Boulevard • Austin, Texas 78759-2439 - PH: 800-695-2919 * FAX: 800-211-5454 • buvboard.corn
MANUFACTURER DEALER DESIGNATION
If Vendor is a manufacturer that sells products through a dealer network and wishes to designate a dealer or multiple
dealers ("Designated Dealers") to receive Cooperative member Purchase Orders on Vendor's behalf, you must complete
this form for each dealer you wish to designate.
Regardless of any Designated Dealers submitted by Vendor, Vendor specifically agrees and acknowledges that any such
designations are for Vendor's convenience only and shall not, if Vendor is awarded a Contract, relieve Vendor of any
obligations under the Contract, including payment of Cooperative service fees on all Purchase Orders submitted to Vendor
or any Designated Dealer. In accordance with the General Terms and Conditions, an awarded Vendor shall remain
responsible and liable for all of its obligations under the Contract and the performance of both Vendor and any of Vendor's
Designated Dealers under and in accordance with the Contract and remain subject to all remedies for default thereunder,
including, but not limited to suspension and termination of Vendor's Contract for nonpayment of service fees.
If awarded, Vendor authorizes the Cooperative, in its sole discretion, to list any Vendor Designated Dealers in the BuyBoard
system and to receive Purchase Orders directly from Cooperative members on behalf of Vendor. To the extent a Vendor
with Designated Dealers receives a Purchase Order directly, it shall be the responsibility of Vendor to appropriately process
such Purchase Order in accordance with the Contract, including but not limited to timely forwarding such Purchase Order to
a Designated Dealer for processing.
The Cooperative reserves the right, in its sole discretion, to refuse addition of, or request removal of, any Designated
Dealer, and Vendor agrees to immediately require such Designated Dealer to cease accepting Purchase Orders or otherwise
acting on Vendor's behalf under the Contract. Further, the Cooperative's administrator shall be authorized to remove or
suspend any or all Designated Dealers from the BuyBoard at any time in its sole discretion.
If you wish to designate a dealer to service a contract awarded under this Proposal Invitation, please list the Designated
Dealer below and have this form signed by an official of your company authorized to make such designation. If you wish
to designate multiple dealers, please duplicate this form as necessary.
NONE
Designated Dealer Name
Designated Dealer Address
City
Phone Number
State
Fax Number
Zip
Email address Designated Dealer Tax ID Number* (*attach W-9)
Designated Dealer Contact Person
MoboTrex, Inc
Your Company Name Signature of Authorized Co -Official
Page 19 of 63
Proposal Forms COMM/NCS v.05.31.2019
Board®
Cooperative Purchasing
12007 Research Boulevard ' Austin, Texas 78759-2439 PH: 800-695-2919 • FAX: 800-211-5454 • buvboard.com
TEXAS REGIONAL SERVICE DESIGNATION
The Cooperative (referred to as "Texas Cooperative" in this form and in the State Service Designation form) offers vendors
the opportunity to service its members throughout the entire State of Texas. If you do not plan to service all Texas
Cooperative members statewide, you must indicate the specific regions you will service on this form. If you propose to
serve different regions for different products or services Included /n your proposal, you must complete and
submit a separate Texas Reg/ona/ Service Des/gnat/on form for each group of products and clearly Indicate
the products or services to which the des/gnatton applies In the space provided at the end of this form. By
designating a region or regions, you are certifying that you are authorized and w111/ng to provide the
proposed products and services In those regions. Des/gnating regions In which you are either unable or
unwilling to provide the speclfled products and services shall be grounds for either rejection of your
proposal or, /f awarded, term/nat/on of your Contract. Additionally, if you do not plan to service Texas Cooperative
members (i.e., if you will service only states other than Texas), you must so indicate on this form.
Regional Education Service Centers 0 I will service Texas
Cooperative members
" statewide.
1 '- ❑ I will not service Texas
Cooperative members
- statewide. I will only
-� service members in the
regions checked below:
C-' p.
Reciion Headquarters
_- °� - _�- ❑ 1 Edinburg
7L_;-- ❑ 2 Corpus Christi
• _ ❑ 3 Victoria
i9 - •: , ❑ 4 Houston
6.•;_ : ❑ 5 Beaumont
` — ❑ 6 Huntsville
_ ,�!- ;�,Y ❑ 7 Kilgore
-' . - "4:,�' ❑ 8 Mount Pleasant
-,3, _` ❑ 9 Wichita Falls
`HZ�.- ••:� .i ❑ 10 Richardson
�' ❑ 11 Fort Worth
'.�" ❑ 12 Waco
�irL r' ❑ 13 Austin
t^ ..I ❑ 14 Abilene
❑ 15 San Angelo
''- ❑ 16 Amarillo
MoboTrex, Inc ❑ 17 Lubbock
❑ 18 Midland
Company Name ❑ 19 El Paso
/��- _ ❑ 20 San Antonio
Signature of Authorized Company Official
Vincent Holdridge ❑ I will not service members
Printed Name of the Texas Cooperative.
Page 20 of 63
Proposal Forms COMM/SVCS v.05.31.2014
PuGooperativu Purchasi► g
12007 Research Boulevard ' Austin, Texas 78759-2439 - PH: 800-595-2919 ' FAX: 800-211-5454 • buvboard.com
If this Texas Regional Service Designation form applies to only one or some of the products and Services proposed by
Vendor, list the products and services to which this form applies here:
Page 21 of 63
Proposal Forms COMM/SVCS v.05.31.2014
Board
Cooperative Purchasing
12007 Research Boulevard ' Austin, Texas 78759-2439 , PH: 800-695-2919 ' FAX: 800-211-5454 ' buyboard.com
STATE SERVICE DESIGNATION
The Cooperative offers vendors the opportunity to service other governmental entities in the United States, including
intergovernmental purchasing cooperatives such as the National Purchasing Cooperative BuyBoard. You must complete
this form if you plan to service the entire United States, or will service only the specific states indicated. (Note: If you plan
to service Texas Cooperative members, be sure that you complete the Texas Regional Service Designation form.)
If you serve different states for different products or services Included In your proposal, you must complete
and submit a separate State Service Designation form for each group of products and clearly Ind/cate the
products or services to which the designation applies In the space provided at the end of this form. By
designating a state or states, you are cert/fy/ng that you are authorized and wllling to prov/de the proposed
products and services In those states. Designating states In which you are either unable or unwllling to
provide the specified products and services shall be grounds for either rejection of your proposal or, if
awarded, terminatlon of your Contract.
Please check 00 all that apply:
❑ I will service all states in the United States.
❑■ I will not service all states in the United States. I will service only the states checked below:
❑ Alabama
❑ Alaska
❑ Arizona
❑ Arkansas
❑ California (Public Contract Code 20118 & 20652)
❑ Colorado
❑ Connecticut
❑ Delaware
❑ District of Columbia
❑ Florida
❑ Georgia
❑ Hawaii
❑ Idaho
❑ Illinois
❑ Indiana
❑ Iowa
❑ Kansas
❑ Kentucky
❑ Louisiana
❑ Maine
❑ Maryland
❑ Massachusetts
❑ Michigan
❑ Minnesota
❑ Mississippi
❑ Missouri
❑ Montana
❑ Nebraska
❑ Nevada
❑ New Hampshire
❑ New Jersey
❑ New Mexico
❑ New York
❑ North Carolina
❑ North Dakota
❑ Ohio
Oklahoma
❑ Oregon
❑ Pennsylvania
❑ Rhode Island
❑ South Carolina
❑ South Dakota
❑ Tennessee
❑■ Texas
❑ Utah
❑ Vermont
❑ Virginia
❑ Washington
❑ West Virginia
❑ Wisconsin
❑ Wyoming
Page 22 of 63
Proposal Forms COMM/SVCS v.05.311019
D p &
Board
Cooperative Purchasing
12007 Research Boulevard , Austin, Texas 78759-2439 • PH: 800-695-2919 1 FAX: 800-211-5454 • buvboard.com
This form will be used to ensure that you can service other governmental entities throughout the United States as
indicated. Your signature below confirms that you understand your service commitments during the term of a
contract awarded under this proposal.
MoboTrex, Inc
Signature of Authorized Company official
Company Name
Vincent Holdridge
Printed Name
If this State Service Designation form applies to only one or some of the products and services proposed by Vendor,
list the products and services to which this form applies here:
Page 23 of 63
Proposal Forms COMM/SVCS v.05.31.2019
P 0 a
cooperative Pnrchesing
12007 Research Boulevard • Austin, Texas 78759-2439 - PH: 800-695-2919 ' FAX: 600-211-5454 ' buvboard,com
NATIONAL PURCHASING COOPERATIVE VENDOR AWARD AGREEMENT
In accordance with the Terms and Conditions associated with this Proposal Invitation, a contract awarded under this
Proposal Invitation may be "piggy -backed" by another governmental entity. The National Purchasing Cooperative is an
intergoverrrmentaf purchasing cooperative formed by certain school districts outside of Texas to serve its members
throughout the United States. If you agree to be considered for a piggy -back award by the National Purchasing
Cooperative, you agree to the Following terms and agree to serve National Purchasing Cooperative members in the states
you have indicated on the State Service Designation form, in your Proposal.
By signing this form, Proposer (referred to in this Agreement as "Vendor") agrees as follows:
1. Vendor acknowledges that if The Local Government Purchasing Cooperative ("Texas Cooperative") awards Vendor a
contract under this Proposal Invitation ("Underlying Award), the National Purchasing Cooperative ("National Cooperative")
may - but is not required to - "piggy -back" on or re -award all or a portion of that Underlying Award ["Piggy -Back Award").
By signing this National Cooperative Vendor Award Agreement ("Agreement"), Vendor accepts and agrees to be bound by
any such Piggy -Back Award as provided for herein.
2. In the event National Cooperative awards Vendor a Piggy -Back Award, the National Cooperative Administrator
("BuyBoard Administrator) will notify Vendor in writing of such Piggy -Back Award, which award shall commence on the
effective date stated in the Notice and end an the expiration date of the Underlying Award, subject to annual renewals as
authorized in writing by the BuyBoard Administrator. Vendor agrees that no further signature or other action is required of
Vendor in order for the Piggy -Back Award and this Agreement to be binding upon Vendor. Vendor further agrees that no
interlineations or changes to this Agreement by Vendor will be binding on National Cooperative, unless such changes are
agreed to by its BuyBoard Administrator in writing.
3. Vendor agrees that it shall offer its goods and services to National Cooperative members at the same unit pricing and
same general terms and conditions, subject to applicable state laws in the state of purchase, as required by the Underying
Award. However, nothing in this Agreement prevents Vendor from offering National Cooperative members better (i.e.,
lower) competitive pricing and more favorable terms and conditions than those in the Underlying Award.
4. Vendor hereby agrees and confirms that it will serve those states it has designated on the State Service Designation
Form of this Proposal Invitation. Any changes to the states designated on the State Service Designation Form must be
approved in writing by the BuyBoard Administrator.
S. Vendor agrees to pay National Cooperative the service fee provided for in the Underlyinq Award based on the amount: of
purchases generated from National Cooperative members through the Piggy -Back Award. Vendor shall remit payment to
National Cooperative on such schedule as it specifies (which shall not be more often than monthly). Further, upon
request, Vendor shall provide National Cooperative with copies of all purchase orders generated from National Cooperative
members for purposes of reviewing and verifying purchase activity. Vendor further agrees that National Cooperative shall
have the right, upon reasonable written notice, to review Vendor's records pertaining to purchases made by National
Cooperative members in order to verify the accuracy of service fees.
6. Vendor agrees that the Underlying Award, including its General Terms and Conditions, are adopted by reference to the
fullest extent such provisions can reasonably apply to the post-proposal/contract award phase. The rights and
responsibilities that would ordinarily inure to the Texas Cooperative pursuant to the Underlying Award shall inure to
National Cooperative; and, conversely, the rights and responsibilities that would ordinarily inure to Vendor in the Underlying
Award shall inure to Vendor in this Agreement. Vendor recognizes and agrees that Vendor and National Cooperative are the
only parties to this Agreement, and that nothing in this Agreement has application to other third parties, including the
Texas Cooperative. In the event of conflict between this Agreement and the terms of the Underlying Award, the terms of
this Agreement shall control, and then only to the extent necessary to reconcile the conflict.
Proposal Forms COMM/SVCS v.05.33.2019
Page 24 of 63
LWBoard
cooperativepu hily-Ing
12007 Research Boulevard • Austin, Texas 78759-2439 - PH: 800-695-2919 * FAX: 800-211-5454 • buyboard.com
7. This Agreement shall be governed and construed in accordance with the laws of the State of Rhode Island and venue
for any dispute shall lie in the federal district court of Alexandria, Virginia.
8. Vendor acknowledges and agrees that the award of a Piggy -Back Award is within the sole discretion of National
Cooperative, and that this Agreement does not take effect unless and until National Cooperative awards Vendor a Piggy -
Back Award and the BuyBoard Administrator notifies Vendor in writing of such Piggy -Back Award as provided for herein.
WHEREFORE, by signing below Vendor agrees to the foregoing and warrants that it has the authority to enter into this
Agreement.
MoboTrex, Inc
Name of Vendor
Signature of Aut onzed Co any Official
11-5-2019
Date
•1: 1
Proposal Invitation Number
Vincent Holdridge
Printed Name of Authorized Company Official
Page 25 of 63
Proposal Forms COMM/SVCS v.05.31.2019
PWC908P#Wq"VV4!rhU5iMn§ 0
12007 Research Boulevard • Austin, Texas 78759-2439 , PH: 800-695-2919 • FAX: 800-211-5454 ' buvboard.com
FEDERAL AND STATE/ PURCHASING COOPERATIVE EXPERIENCE
The Cooperative strives to provide its members with the best services and products at the best prices available from
vendors with the technical resources and ability to serve Cooperative members. Please respond to the Following questions.
1. Provide the dollar value of sales to or through purchasing cooperatives at or based on an established catalog or
market price during the previous 12-month period or the last fiscal year: $ 3,550.000,00 . (The period of the 12
month period is Nov / art ). In the event that a dollar value is not an appropriate measure of the sales,
provide and describe your own measure of the sales of the items).
2. By submitting a proposal, you agree that, based on your written discounting policies, the discounts you offer the
Cooperative are equal to or better than the best price you offer other purchasing cooperatives for the same items
under equivalent circumstances.
3. Provide the information requested below for other purchasing cooperatives for which Proposer currently serves, or in
the past has served, as an awarded vendor. Rows should be added to accommodate as many purchasing
cooperatives as required.
1. Federal General Services Administration N
2. T-PASS (State of Texas)
Y Traffic Signal Equipment
3. OMNIA Partners N !
4. Sourcewell (NIPA) N '
5. E&I Cooperative N
6. Houston Galveston Area Council (HGAC} I Y Traffic Signal Equipment
7. Choice Partners N
8. The Interlocal Purchasing System (TIPS) N
9. Other f i
❑ MY COMPANY DOES NOT CURRENTLY HAVE ANY OF THE ABOVE OR SIMILAR TYPE CONTRACTS.
CURRENT BUYSOARD VENDORS
If you are a current Buy8oard vendor in the same contract category as proposed in this Proposal Invitation, indicate the
discount for your current BuyBoard contract and the proposed discount in this Proposal. Explain any difference between
your current and proposed discounts.
Current Discount (0/o): Avg 20%
Proposed Discount (%). Avg 20%
Explanation: Our intent is to hold our discounts from contract 534-17
Proposal Forms COMM/SVCS v.05.31.2019
Page 26 of 63
D a a
Board
Wcappere"Ve Purcha;100
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com
By signature below, I certify that the above is true, complete and accurate and that I am authorized by my company to
make this certification.
MoboTrex, Inc
Company Name
Signature of Authorized Co y Official
Vincent Holdridge
Printed Name
Page 27 of 63
Proposal Forms COMM/SVCS v.05.31.2019
P p
�,
Hoard
Cooperative Purchasing
12007 Research Boulevard • Austin, Texas 78759-2439 - PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com
GOVERNMENTAL REFERENCES
For your Proposal to be considered, you must supply a minimum of five (5) individual governmental entity references. The
Cooperative may contact any and all references provided as part of the Proposal evaluation. Provide the information
requested below, including the existing price/discounts you offer each customer. The Cooperative may determine whether
prices/discounts are fair and reasonable by comparing prices/discounts stated in your Proposal with the prices/discounts
you offer other governmental customers. Attach additional pages if necessary,
Quantity/
Entity Name Contact Phone# Email Address Discount Volume
1 See attached sheet
5.
Do you ever modify your written policies or standard governmental sales practices as identified in the above chart to give
better discounts (lower prices) than indicated? YES ❑ NO ❑■ If YES, please explain:
By signature below, I certify that the above is true and correct and that I am authorized by my company to make this
certification.
MoboTrex, Inc
Company Name
Signature of Authorized Company Official
Vincent Holdridge
Printed Name
Proposal Forms COMM/SVCS v.05.31.2019
Page 28 of 63
BIDDER REFERENCES
Please list three (3) references, preferably a Government (local, county, state) or Educational Agency that
may be contacted:
1. COMPANY NAME: San Antonio, City of
ADDRESS: 223 S. Cherry Street
CITY 1 STATE 1 ZIP: San Antonio, TX 78203
PHONE NO.: 210-207-4048
NAME OF CONTACT: Jorge Garcia
2. COMPANY NAME: Dallas, City of
ADDRESS: 3204 Canton Street
CITY / STATE 1 ZIP: Dallas, TX 75226
PHONE NO.: 214-671-9249
NAME OF CONTACT: Dana Driggars
3. COMPANY NAME: Austin, City of
ADDRESS: 1501 Toomey Rd
CITY 1 STATE 1 ZIP: Austin, TX 78704
PHONE NO.: 512-974-7050
NAME OF CONTACT: Ramona Aguilar
BIDDER REFERENCES
Please list three (3) references, preferably a Government (local, county, state) or Educational Agency that
may he contacted:
t COMPANY NAME: New Braunfels, City of
ADDRESS: 424 S Castell Ave
CITY I STATE I ZIP: New Braunfels, TX 78130
PHONE NO.: 830-221-4049
NAME OF CONTACT: Chris Nowak
2. COMPANY TAME: Harlingen, City of
ADDRESS: 404 54th Street
CITY 1 STATE 1 ZIP: Harlingen, TX 78550
PHONE NO.: 956-216-5234
NAME OF CONTACT: Eli Cruz
3. COMPANY NAME: Duncanville. City of
ADDRESS: 330 Shady Trail Dr
CITY 1 STATE 1 ZIP: Duncanville, TX 75137
PHONE NO.: 972-780-5059
NAME OF CONTACT: John Borchardt
D a 0
Board
Cooperative Purchasing
12007 Research Boulevard ' Austin, Texas 78759-2439 • PH: 800-695-2919 ' FAX: 800-211-5454 ' buvboard.com
MARKETING STRATEGY
For your Proposal to be considered, you must submit the Marketing Strategy you will use if the Cooperative accepts all or
part of your Proposal. (Exama/e: Explain how your company will initially inform Cooperative members of your BuyBoard
contract, and how you will continue to support the BuyBoard for the duration of the contract period.)
Attach additional pages if necessary.
We plan to continue to market our buyboard contract through customer visits, trade shows, trainings, and email.
Mobotrex, Inc
Company Name
Signature of Authorize Company Official
Vincent Holdridge
Printed Name
Proposal Forms COMM/SVCS v.05.31.2019
Page 29 of 63
Beard
Cooperative Purchasing
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com
CONFIDENTIAL/ PROPRIETARY INFORMATION
A. Public DisCiQsure Laws
All Proposals, forms, documentation, or other materials submitted by Vendor to the Cooperative in response to this
Proposal Invitation, including catalogs and priceiists, may be subject to the disclosure requirements of the Texas Public
Information Act (Texas Government Code chapter 552.001, et. seq.) or similar disclosure law. Proposer must clearly
identify on this form any information in its Proposal (including forms, documentation, or other materials submitted with the
Proposal) that Proposer considers proprietary or confidential. If proposer fails to properly identify the information, the
Cooperative shall have no obligation to notify Vendor or seek protection of such information from public disclosure should a
member of the public or other third parry request access to the information under the Texas Public Information Act or
similar disclosure taw. Proposer will be notified of any third party request for information In a Proposal that Proposer has
identified in this form as proprietary or confidential.
Does your Proposal (including Forms, documentation, or other materials submitted with the Proposal) contain Information
which Vendor considers proprietary or confidential?
Please check (V) one of the faflowlna:
MNO, I certify that none of the information included with this Proposal is considered confidential or proprietary,
YE& I certify that this Proposal contains information considered confidential or proprietary and ail such information is
specifically identified on this forms.
If you responded "YES", you must identify below the specific information you consider confidential or proprietary. List each
page number, form number, or other information sufficient to make the information readily identifiable. The Cooperative
and its Administrator will not be responsible for a Proposer's failure to clearly identify infon-nation considered confidential or
proprietary. Further, by submitting a Proposal, Proposer acknowledges that the Cooperative and its Administrator will
disclose information when required by law, even if such information has been identified herein as information the vendor
considers confidential or proprietary.
Confidential I Proprietary Information:
(Aaach addioanal sheets if needed.)
Proposal Farms Comm/Svc5 v.05.31.2415
Page 30 of 63
Ba�rrd
Cooperative PercWiWng
12007 Research Boulevard ' Austin, Texas 78759-2439 - PH: 800-695-2919 ' FAX: 800-211.5454 ' buyhoard,com
S. Cooyrirliht Information
Roes your Proposal (including forms, documentatlon, or other materials submitted with the Proposal) contain copyright
information?
Please Check M one gf the following;
NO, Proposal (including forms, documentation, or other materials submitted with the Proposal) does not
contain copyright information.
❑ YES, Proposa# (including Forms, documentation, or other materials submitted with the Proposal) does
Contain copyright information.
If you responded "YES", identify below the specific documents or pages containing copyright information.
Copyright Information:
(Attach additional sheety 1(needed. )
C. Consent to Release Confidential/Praorietau/Copyright Information to 6uySoard Members
BuyBoard members (Cooperative and nonprofit members) seeking to make purchases through the BuyBoard may wish to
view information included in the Proposals of awarded Vendors. If you identified Information on this form as confidential,
proprietary, or subject to copyright, and you are awarded a BuyBoard contract, your acceptance of the BuyBoard contract
award constitutes your consent to the disclosure of such information to BuyBoard members, including posting of such
information on the secure BuyBoard website for members. Note: Neither the Cooperative nor its Administrator will be
responsible for the use or distribution of information by BuyBoard members or any other party.
D. Consertt_to Rahease ProposalTabulati
Notwithstanding anything in this Confidential/Proprietary Information form to the contrary, by submitting a Proposal,
Vendor consents and agrees that, upon Contract award, the Cooperative may publically release, including posting on the
public BuyBoard website, a copy of the proposal tabulation for the Contract including Vendor name; proposed
catalog/pricelist name(s); proposed percentage discounts), hourly labor rate(s), or other specified pricing; and Vendor
award or non -award information.
By signature below, I certify that the information in this form is true, complete, and accurate and that I am authorized by
my company to make this certification and all consents and agreements contained herein.
MoboTrex, Inc
Company Name
Y
Signature of Authorized Camp
Vincent Holdridge
Printed Name
11-5-2019
Date
Propmal Forms COMMISKS v.05.31.2014
Page 31 of 63
D 0 &
Cooperative Purchasing
12007 Research Boulevard, Austin, Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buvboard.com
VENDOR BUSINESS NAME
By submitting a Proposal, Proposer is seeking to enter into a legal contract with the Cooperative. As such, a Proposer must
be an individual or legal business entity capable of entering into a binding contract. Proposers, must completely and
accurately provide the information requested be#ow or your Proposal may be deemed non -responsive.
Name of Proposing Company: MoboTrex, Inc
(List the &ad name of the company seeking to contract with the Cooperative. Do NOT list an assumed name, dba, aka, at. here. Such information may
be provided below. If you are submitting a joint proposal with another entity to provide the same proposed goods or services, each submitting entity
should complete a separate vendor information form. Separately operating legal business entities, even if affiliated entities, which propose to provide
goods or services separately must submit their own Proposals.)
Please check [ y'j_Qne _Qf_th_e fyllQwi ft ;
Type of Business:
Individual/Sole Proprietor
Corporations x
Limited Liability Company
Partnership
Other If other, identify
State of Incorporation (if applicable):
IOWA
Federal Employer Identification Number: 36-2656899
(Vendor must include a completed IRS W-9 form with their proposal)
List the Name(s) by which Vendor, if awarded, wishes to be identified on the BuyBoard: (lvote: ffdifferent [Fran the Name of
Proposing Company listed above, only valid trade names {dba, aka, etc.} of the Proposing Company may be used and a -Vpy of your Assumed Name
Certi6cate(s}, if applicable, moist he attached.)
Proposal Forms COMM/ VCS v.a5.31.2419
Page 32 of 63
Form
(Rev.
Depart
Interne
W-9
Request for Taxpayer
Give Form to the
)ctoter2018)
Identification Number and Certification
requester. Do not
ment of the Treasury
send to the IRS.
I Reve.iue Service
► Go to wwwJrs.gov/FormW9 for instructions and the latest information.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
MobOTrex, Inc
2 Business name/disregarded entity name, if different from above
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the
4 Exemptions (codes apply only to
following seven boxes.
certain entities, not Individuals; see
❑ individuaVsole proprietor or ElC Corporation 0 S Corporation ElPartnership ElTrust/estate
instructions on page 3):
single -member LLC
Exempt payee code (if any)
❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P-Partnership) ►
Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check
Exemption from FATCA repotting
LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC :s
code (If any)
another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
ill Other (see instructions) ►
1 (App&ps to eccourrts ma0tairred outside ffte U.S.)
5 crass (number, steet, and apt. or suite no.) See instructions.
Requester's name and address (optional
109 West 55th Street
B City, state, and ZIP code
�Daven ort, IA 52806
7 List account number's) here (optional)
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding. For individuals, this is generally your social security number (SHowever, for a - EF1
-
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see Now to get a
TIN, later. or
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and FEmployer Identification number
Number Tc Give the Requester for guidelines on whose number to enter. F-T-1 I I I I I I i
Under penalties of perjury, i certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. i am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA cedes) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct,
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign Slgnetureof /jj
Here U.S. person ► - LL
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.Irs.gov1FermV✓9.
Purpose of Form
An individt.al or entity (Form W-9 requester) who is required to file an
information return with the IRS must obtain your correct taxpayer
identification number (TIN) which may be your social security number
(SSN), individual taxpayer identification number (ITIN), adoption
taxpayer identification number (ATIN), or employer identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of information
returns include, but are not limited to, the following.
• Form 1099-INT (interest eamed or paid)
Data ► % / D a`/ a--Z 9
• Form 1099-DIV (dividends, including those from stocks or mutual
funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cat. No. 10231 X Form W-9 (Rev. 10-2018)
P a a
Beard
WcooperefivepurchmFing
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-595-2919 ' FAX: 800-211-5454 ' buyboard.com
EDGAR VENDOR CERTIFICATION
(2 CFR Part 200 and Appendix II)
When a Cooperative member seeks to procure goods and services using funds under a Federal grant or contract, specific
federal laws, regulations, and requirements may apply in addition to those under state law. This includes, but is not limited
to, the procurement standards of the Uniform Administrative Requirements, Cost Principles and Audit Requirements for
Federal Awards, 2 CFR 200 [sometimes referred to as the "Uniform Guidance" or new "EDGAR' ]. All Vendors submitting
proposals must complete this EDGAR Certification Form regarding Vendor's willingness and ability to comply with certain
requirements which may be applicable to specific Cooperative member purchases using federat grant Funds. This
completed form will be made available to Cooperative members for their use while considering their purchasing options
when using federal grant funds. Cooperative members may also require Vendors to enter into ancillary agreements, in
addition to the BuyBoard contract's genera( terms and conditions, to address the member's specific contractual needs,
Including contract requirements for a procurement using federal grants or contracts.
For each of the Items below, Vendor should certify Vendor's agreement and ablllty to comply, where
applicable, by having Vendor's authorized representative complete and Initlal the applicable boxes and sign
the acknowledgment at the end of this form. If you fall to complete any Item In this form, the Cooperative
will consider and may list the Vendor's response on the BuyBoard as "NO,"the Vendor Is unable or unwllling
to comply. A 11NO" response to any of the items may, if applicable, impact the ability of a Cooperative member to
purchase from the Vendor using federal funds.
I. Vendor Violation or Breach of Contract Terms:
Contracts for more than the Simplified Acquisit;on Threshold, which is the inflation adjusted amount determined by the
Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council (Councils) as authorized by 41 USC
1908, must address administrative, contractual, or legal remedies in instances where contractors violate or breach contract
terms, and provide for such sanctions and penalties as appropriate.
Provisions regarding Vendor default are included in the BuyBoard General Terms and Conditions, including Section E.18,
Remedies for Default and Termination of Contract. Any Contract award will be subject to such BuyBoard General Terms
and Conditions, as well as any additional terms and conditions in any Purchase Order, Cooperative member ancillary
contract, or Member Construction Contract agreed upon by Vendor and the Cooperative member which must be consistent
with and protect the Cooperative member at least to the same extent as the BuyBoard Terms and Conditions.
The remedies under the Contract are in addition to any other remedies that may be available under law or in equity. By
submitting a Proposal, you agree to these Vendor violation and breach of contract terms.
2. Termination for Cause or Convenience:
For any Cooperative member purchase or contract in excess of $10,000 made using federal funds, you agree that the
Following term and condition shall apply:
the Cooperative member may terminate or cancel any purchase order under this Contract at any time, with or without
cause, by providing seven (7) business days advance written notice to the Vendor, If this Agreement is terminated in
accordance with this Paragraph, the Cooperative member shall only be required to pay Vendor for goods or services
delivered to the Cooperative member prior to the termination and not otherwise retumed in accordance with Vendor's
return policy. If the Cooperative member has paid Vendor for goods or services not yet provided as of the date of
termination, Vendor shall immediately refund such payments).
If an alternate provision for termination of a Cooperative member purchase for cause and convenience, including the
manner by which it will be effected and the basis for settlement, Is included in the Cooperative member's purchase order,
ancillary agreement, or Member Construction Contract agreed to by the Vendor, the Cooperative member's provision shall
control.
Proposal Forms COMMi511CS v.05.31.2014
Wage 33 of 53
P 0 0
Beard
Cooperative Purchasing
12007 Research Souievard • Austin, Texas 78759-2439 PH: 800-695-2919 • FAX: 800-211-5454 • buyhoard.corn
3. Equal Employment Opportunity:
Except as otherwise provided under 41 CFP Part 60, all Cooperative member purchases or contracts that meet the
definition of "federally assisted construction contract" in 41 CFR. Part 60-1.3 shall be deemed to include the equal
opportunity clause provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, "Equal Employment
Opportunity" (30 FIR 12319, 12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375,
"Amending Executive Order 11246 Relating to Equal Employment Opportunity," and implementing regulations at 41 CFR
Part 60, "Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor."
The equal opportunity clause provided under 41 CFR 60-1.4(b) Is hereby incorporated by reference. Vendor agrees that
such provision applies to any Cooperative member purchase or contract that meets the definition of "Federally assisted
construction contract" in 41 CFR Part 60-1.3 and Vendor agrees that it shall comply with such provision,
4. Davis -Bacon Act:
When required by Federal program legislation, Vendor agrees that, for all Cooperative member prime construction
contracts/purchases in excess of $2,000, Vendor shall comply with the Davis -Bacon Act (40 USC 3141-3144, and 3146-
3148) as supplemented by Department of Labor regulations (29 CFR Part 5, "Labor Standards Provisions Applicable to
Contracts Covering Federally Financed and Assisted Construction" J. In accordance with the statute, Vendor is required to
pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determinate made by
the Secretary of Labor. In addition, Vendor shall pay wages not less than once a week.
Current prevailing wage determinations issued by the Department of Labor are available at wdol. ov. Vendor agrees that,
for any purchase to which this requirement applies, the award of the purchase to the Vendor is conditioned upon Vendor's
acceptance of the wage determination.
Vendor further agrees that it shall also comply with the Copeland "Anti -Kickback" Act (40 USC 3145), as supplemented by
Department of Labor regulations (29 CFR Part 3, "Contractors and Subcontractors on Public Building or Public Work
Financed in Whole or in Part by Loans or Grants from the United States"), The Act provides that each contractor or
subrecipient must be prohibited From inducing, by any means, any person employed in the construction, completion, or
repair of public work, to give up any part of the compensation to which he or she is otherwise entitled.
5. Contract Work Hours and Safety Standards Act:
Where applicable, for all Cooperative member contracts or purchases in excess of $100,000 that involve the employment of
mechanics or laborers, Vendor agrees to comply with 40 USC 3702 and 3704, as supplemented by Department of Labor
regulations (29 CFR Part 5). Under 40 USC 3702 of the Act, Vendor is required to compute the wages of every mechanic
and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible
provided that the worieer is compensated at a rate of not less than one and a half times the basic rate of pay for all hours
worked in excess of 40 hours in the work week. The requirements of 40 USC 3704 are applicable to construction work and
provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are
unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles
ordinarily available on the open market, or contracts for transportation or transmission of intelligence.
6. Right to Inventions Made Under a Contract or Agreement:
If the Cooperative member's Federal award meets the definition of "funding agreement" under 37 CFR 401.2(a) and the
recipient or subreclplent wishes to enter into a contract with a small business firm or nonprofit organization regarding the
substitution of parties, assignment or performance or experimental, developmental, or research work under that "funding
agreement," the recipient or subrecipient must comply with the requirements of 37 CFR Part 401, "Rights to Inventions
Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative
Agreements," and any implementing regulations issued by the awarding agency.
Vendor agrees to comply with the above requirements when applicable.
Proposal forms COMM/WC5 v.05.31.2019
Page 34 of 63
P 0 a
Board
Cooperative Purchasing
12007 Research Boulevard ' Austin, Texas 78759-2439 - PH: 800-695-2919 . FAX: 800-211-5454 ' buvboard.com
7. Clean Air Ad and Federal Water Pollution Control Act:
Clean Air Act (42 USC 7401-7671q.) and the Federal Water Pollution Control Act (33 USC 1251-1387), as amended —
Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the non -Federal award to
agree to comply with all applicable standards, orders, or regulations issued pursuant to the Clean Air Act (42 USC 7401-
7671q.) and the Federal Water Pollution Control Act, as amended (33 USC 1251-1387). Violations must be reported to the
Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA).
When required, Vendor agrees to comply with all applicable standards, orders, or regulations issued pursuant to the Clean
Air Act and the Federal Water Pollution Control Act,
8. Debarment and Suspension:
Debarment and Suspension (Executive Orders 12549 and 12689) — A contract award (see 2 CFR 180.220) must not be
made to parties listed on the government -wide exclusions in the System for Award Management (SAM), in accordance with
the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR Part 1966 Comp. p. 189) and 12689 (3
CFR Part 1989 Comp. p. 235), "Debarment and Suspension." SAM Exclusions contains the names of parties debarred,
suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority
other than Executive Order 12549.
Vendor certifies that Vendor is not currently listed on the government -wide exclusions in SAM, is not debarred, suspended,
or otherwise excluded by agencies or declared ineligible under statutory or regulatory authority other than Executive Order
12549. Vendor further agrees to immediately notify the Cooperative and all Cooperative members with pending purchases
or seeking to purchase from Vendor if Vendor is later listed on the government -wide exclusions in SAM, or is debarred,
suspended, or otherwise excluded by agencies or declared ineligible under statutory or regulatory authority other than
Executive Order 12549.
9. Byrd Anti -Lobbying Amendment:
Byrd Anti -Lobbying Amendment (31 USC 1352) -- Vendors that apply or bid for an award exceeding $100,000 must file the
required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to
pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member
of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any
Federal contract, grant or any other award covered by 31 USC 1352. Each tier must also disclose any lobbying with non -
Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to
tier up to the non -Federal award. As applicable, Vendor agrees to file all certifications and disclosures required by, and
otherwise comply with, the Byrd Anti -Lobbying Amendment (31 USC 1352).
10. Procurement of Recovered Materials:
For Cooperative member purchases utilizing Federal funds, Vendor agrees to comply with Section 6002 of the Solid Waste
Disposal Act, as amended by the Resource Conservation and Recovery Act where applicable and provide such information
and certifications as a Cooperative member may require to confirm estimates and otherwise comply. The requirements of
Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR
Part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory
level of competition, where the purchase price of the item exceeds $10,000 or the value of the quantity acquired during the
preceding fiscal year exceeded $10,000; procuring solid waste management services in a manner that maximizes energy
and resource recovery, and establishing an affirmative procurement program for procurement of recovered materials
identified in the EPA guidelines.
11. Profit as a Separate Element of Price:
For purchases using federal funds in excess of the Simplified Acquisition Threshold, a Cooperative member may be required
to negotiate profit as a separate element of the price. See, 2 CFR 200.323(b). When required by a Cooperative member,
Vendor agrees to provide information and negotiate with the Cooperative member regarding profit as a separate element
of the price for a particular purchase. However, Vendor agrees that the total price, including profit, charged by Vendor to
the Cooperative member shall not exceed the awarded pricing, including any applicable discount, under Vendor's
Cooperative Contract.
Proposal Forms COMM/SVCS v.05.31.1019
Page 35 of 63
Ai Board
Cooperative Purchasing
12007 Research Boulevard . Austin, Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buvboard.com
12. General Compliance and Cooperation with Cooperative Members:
In addition to the foregoing specific requirements, Vendor agrees, in accepting any Purchase Order from a Cooperative
member, it shall make a good faith effort to work with Cooperative members to provide such information and to satisfy
such requirements as may apply to a particular Cooperative member purchase or purchases including, but not limited to,
applicable recordkeeping and record retention requirements.
Vendor Certification:
YES, I agree or
Vendor Certification Item No.
NO I do NOT agree
Initial
1. Vendor Violation or Breach of Contract Terms
YES
1
2. Termination for Cause or Convenience
YES
3. Equal Employment Opportunity
YES
4. Davis -Bacon Act
YES
5. Contract Work Hours and Safety Standards Act
YES
YES
, /'
6. Right to Inventions Made Under a Contract or Agreement
7. Clean Air Act and Federal Water Pollution Control Act
YES
A
8. Debarment and Suspension
YES
9. Byrd Anti -Lobbying Amendment
YES%
10. Procurement of Recovered Materials
YES/
11. Profit as a Separate Element of Price
YES
12. General Compliance and Cooperation with Cooperative Members
YES
f.
By signature below, I certify that the information in this form is true, complete, and accurate and that I am authorized by
my company to make this certification and all consents and agreements contained herein.
MoboTrex, Inc
Company Name
Signature of Authorized Company Official
Vincent Holdridge
Printed Name
Proposal Forms COMM/SVCS v.05.31.2019
Page 36 of 63
DuBoard
CooperativePureftsising ®
12007 Research Boulevard * Austin, Texas 78759-2439 - PH: 800-695-2919 * FAX: 800-211-5454 • buvboard.com
PROPOSAL INVITATION QUESTIONNAIRE
The Cooperative will use your responses to the questions below in evaluating your Proposal and technical and financial
resources to provide the goods and perform the services ("Work' under the BuyBoard contract contemplated by this
Proposal Invitation ("Contract'. Proposers must fully answer each question, numbering your responses to correspond to
the questions/numbers below, Proposers must complete below or attach your responses to this questionnaire, sign where
indicated below, and submit the signed questionnaire and your responses to all questions in one document with your
Proposal. You must submit the signed questionnaire and responses with your Proposal or the Proposal will
not be considered.
List the number of years Proposer has been in business and former business names (if applicable). Note whether your
company is currently for sale or involved in any transaction that would significantly alter its business or result in
acquisition by another entity.
We have been in business for 50 years this year.
2. Describe the resources Proposer has to manage staff and successfully perform the Work contemplated under this
Contract. State the number and summarize the experience of company personnel who may be utilized for the Work,
including those who will be available to Cooperative members for assistance with project development, technical issues,
and product selection for Work associated with this Contract.
We have facilities in Austin, TX. We have 4 sales people for Texas and Oklahoma.
3. Describe Proposers financial capability to perform the Contract. State or describe the firm's financial strength and
rating, bonding capacity, and insurance coverage limits. State whether the firm, or any of the firm's past or present
owners, principal shareholders or stockholders, or officers, have been a debtor party to a bankruptcy, receivership, or
insolvency proceeding in the last 7 years, and identify any such debtor party by name and relationship to or position
with your firm.
We have a strong financial performance history and have never been party to bankruptcy.
Proposal Forms COMM/SVCS v.05.31.2019
Page 37 of 63
A a 0
Board
Cooperative Purchasing
12007 Research Boulevard • Austin, Texas 78759-2439 - PH: 800-695-2919 • FAX: 800-211-5454 • buvboard.com
4. Does your company have any outstanding financial judgments and/or is it currently in default on any loan or financing
agreement? If so, provide detailed information on the nature of such items and prospects for resolution.
NONE
5. List all contracts, if any, in the last 10 years on which Proposer has defaulted, failed to complete or deliver the work, or
that have been terminated for any reason. For each such contract, provide the project name, scope, value and date
and the name of the procuring entity. Fully explain the circumstances of the default, failure to complete or deliver the
work, or termination.
NONE
6. List all litigation or other legal proceedings (including arbitration proceedings), if any, in the last 10 years brought
against your firm, or any of the firm's past or present owners, principal shareholders or stockholders, officers, agents or
employees, that relates to or arises from a contract similar to this Contract or the work contemplated under this
Contract. Provide the style of the lawsuit or proceeding (name of parties and court or tribunal in which filed), nature of
the claim, and resolution or current status.
NONE
By signature below, I certify that the information contained in and/or attached to this Proposal Invitation
Questionnaire in response to the above questions is true and correct and that I am authorized by my
company to make this certification.
MoboTrex, Inc
Company Name
Signature of Authorized Company Official
Proposal Forms COMM/SVCS v.05.31.2019
Page 38 of 63
9%..
9;�-r
.Board
Cooperative Purchasing
12007 Research Boulevard ' Austin, Texas 78759-2439 , PH: 800-695-2919 ' FAX: 800-211-5454 ' buvboard.com
REQUIRED FORMS CHECKLIST
(Please check (J) the following)
Completed: Proposer's Agreement and Signature
[�] Completed: Vendor Contact Information
Completed: Felony Conviction Disclosure and Debarment Certification
Completed: Resident/ Nonresident Certification
E� Completed: No Israel Boycott Certification
F� Completed: No Excluded Nation or Foreign Terrorist Organization Certification
Completed: Historically Underutilized Business (HUB) Certification)
[� Completed: Construction Related Goods and Services Affirmation
Completed; Deviation/Compliance
Completed: Location/Authorized Seller Listings
LJ Completed: Manufacturer Dealer Designation
Completed: Texas Regional Service Designation
ECompleted: State Service Designation
[� Completed: National Purchasing Cooperative Vendor Award Agreement
E Completed: Federal and State/Purchasing Cooperative Experience
Completed: Governmental References
_ Completed: Marketing Strategy
[� Completed: Confidential/Proprietary Information
E/ Completed: Vendor Business Name with IRS Form W-9
['J Completed: EDGAR Vendor Certification
Completed: Proposal Invitation Questionnaire
Completed: Required Forms Checklist
Completed: Proposal Specification Form with Catalogs/Pricelists
'Gitalogs/Pncelists must be submitted with proposal response or response will not oe mnsioered.
Proposal Forms COMM/SVCS v.05.31.2019
Page 39 of 63
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EXHIBIT C
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIO
For vendor doing business with local governmental -entity
This questionnaire reflects changes made io the law by H.B. 23. 94111 Leg., Regular Session
OFROEUSEONLY
This questionnaire is being liled in accordance with Chapter 176. L xal Government Code, by a vendor who
Dare peceyyec
has a business relationship as defined by Section 176-001(1-a) with a local governmental enlily and the
vendor meats requirements under Section 176.1006(a)-
By law this questionnaire must be liled with the records adminisiralor of the Icc-aJ gnvemmenlal entity not laler
than the 7th business day after the dale the vendor becomes aware of facts that require the sla;ement io be
filed. Sap Section 176-OcCa-1), LccaJ Government Code.
A vendor commits an offense if the vendor knowingly violates Section 176.006. Local Government Code. Ar
cdense under tis section is a rnisdemeanor.
t N ame of vendor who has a business relationship with local governmental entity.
MoboTrex, Inc
OhedLthis box it you am filing an updmb to pmviousfyfiled quaff ionnaira. (The law requires mat you No an updates
completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which
you became aware that the originally filed questionnaire was incampleta Or inaccurate.)
3 Name of local government officer about whom the information is being disclosed,.
N/A
Name of Cl-- :er
41 Describe each em ployment or other business relationship with the local government officer, or family member of the
officer, as described by Sectio n 176.002 (a) (2) (A). Also describe any familyrelationshipwith thelIOcalgovernmentofficer.
Complete subparts AandBloreach employmentorbusinessrelationship described. Attachadditionalpages; tothis Form
CIO as necessary.
A- Is the local government officer or a family member of the officer receiving or likely to recaiwe taxable in-:
other than irrwastment income, from the vendor?
Yes FX No
B- Is the vendor receive ing or likely to receive taxable income, other than investment income, from Or at the direction
of the local government officer Or a family member of the officer AND the taxable income is not reoeived from the
local governmental entity?
Yes FXNo
51 Deseribreeach employment or business relationship that the vendor named in Section 1 maintains with a corporation or
other business entity with respect to which the local government officer serves as an officer or director. or holds an
ownership inwirest of one percent or more.
NONE
❑ check in s box if the vendor has given the local g overn ment off cer or a fam ily member of the officer One or more gifts
as described in Section 176.UQ3(a)(2)(13), exc uding gifts described .n Section 176-002{a-1j.
01 /26/2023
Signaturia Or vendor cloing business Vn M4 govemmenta entity ja-2
Form provided by Texas Ethics Commission rrrrw.athics.statoAx.us fjevired 11irml
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
A complete copy of Chapter 176 of the Local Government Cade may be found at http lvww. statutes_legis_state.tr .
DocsdL +htrn+LG_ 176.him. For easy reference. below are some of the sections cited on this farm.
Local Government Code l 1 M001(1-a): "Business relationship" means a connection between two or more parties
cased on corrn-ercial activity of one of the parties. The term does not include a connection based on:
(A) a Iran saction that is s ubject to rate or fee regulation by a federal, state, or local governmental entity or ar,
agency of a federal, state, or local governmental entity;
(B) a transaction conducted at a price and subject to terms available to the public; or
(C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and
that is subject to regular exam i nation by, and reporting to, that agency.
Local Govemment Cade 4176.01]Wa}(2)(A) and (B):
(a) A local government officer shall file a conflicts disclosure statementwith respect to avendor if:
(2) thevendor:
(A) has an employment or other business relationship with the local government officer or a
family member of the officer that results in the officer or family member receiving taxable
income, other than investment income, that exceeds $2,500 during the 12-month period
preceding the date that the officer becomes aware that
(i) acontract between the local governmental entity and vendor has been executed;
or
(i i) the local governmental entity is considering enlering into a contract with tii.
vendor,
(B) has given to the localgovernment officer orafamily memberofthe off icerone ormore gifts
that have an aggregate value of more than $100 in the 12-month period preceding the date th e
officer becomes aware that:
(i) a oontract between the local governmental entity and vendorhas been executed; or
(i i) the local governmental entity is considering entering into a contract with the vendor.
Local Government Code 4176.006(a) and (a-1)
(a) Avendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship
with a local governmental entity and:
(1) has an employment or other business relationship with a local government officer of that local
governmental entity, or a fam ily member of the officer, descri bed by Section 176.003(a)(2) (A);
(2) has given a local government officer of that I oval govern mental entity, or a family member of the
officer. one or more gifts with the aggregate value specified by Section 176.003(a){2)(B), excluding any
gift described by Section 176.003(a-1); or
(3) has a family relationship with a local government officer of that Iocal governmental entity.
{a-1 j The completed conflict of interest questionnaire must be filed with the appropriate records administrator
not later than the seventh business day after the later of:
(1) the date that the vendor:
(A) begins discussions or negotiations to enter into a contract with the local governmental
entity; or
(B) subm its to the local governmental entity an application. response to a request for proposals
or bids, correspondence, or another writing related to a potential contract with the local
governmental entity; or
(2) the date the vendor becomes aware:
(A) of an employment or other business relationship with a local government officer, or a
family member of the officer, described by Subsection (a);
(B) that the ven dor has given one or mare gifts described by Subsection (a); or
(G) of a family relationship with a local government officer_
Form provided by Texas Dhics Commission www.ethics.state.U.us REMsed 111r20_'
City of Fort Worth, Texas
Mayor and Council Communication
DATE: 01/10/23 M&C FILE NUMBER: M&C 23-0003
LOG NAME: 13P COOP TRAFFIC SIGNAL EQUIPMENT AW TPW
SUBJECT
(ALL) Authorize Execution of a Purchase Agreement with MoboTrex, Inc. in an Annual Amount Up to $250,000.00 for Traffic Battery Backup
Systems for the Transportation & Public Works Department Using BuyBoard Cooperative Contract No. 608-20
RECOMMENDATION:
It is recommended that the City Council authorize execution of a purchase agreement with MoboTrex, Inc. in an annual amount up to $250,000.00
for traffic battery backup systems for the Transportation & Public Works Department using BuyBoard Cooperative Contract No. 608-20.
DISCUSSION:
The Transportation and Public Works Department contacted the Purchasing Division to enter into an agreement with MoboTrex, Inc.
under BuyBoard 608-20 for battery backup systems for traffic signals. Most of the traffic signals in the City of Fort Worth (City) do not have a
battery backup system that provides full operation of the signal during power outages. The City experienced approximately 300 traffic signal
outages and 1000 flashing traffic signals in a six month period due to issues with the power. The inoperable or flashing traffic signals
require drivers to treat these signals as all way stops, however, many drivers treat these signals as a green light, causing hazardous safety
conditions. The objective of installing traffic signal battery backup units is to increase public safety and reduce traffic congestion by allowing traffic
signals to fully function even during a power failure. This will eliminate the need to dispatch police or signal technicians to control traffic or set up
temporary signs.
Staff recommends executing an agreement with MoboTrex, Inc., using BuyBoard Cooperative Contract No. 608-20. This cooperative agreement
has a term through May 31, 2023 with no options to renew. Cooperative contracts offer fixed discounts. Staff reviewed the pricing and determined
it to be fair and reasonable.
Upon City Council's approval, this agreement will commence upon execution by both parties and will expire May 31, 2023.
Funding is budgeted in the TPW Dept Highway & Streets Department's General Capital Projects Fund for the purpose of funding the FY 2023
Paygo Traffic Signal project, as appropriated.
State law provides that a local government purchasing an item under a cooperative purchase agreement satisfies any state law requiring that the
local government seek competitive bids for purchase of the item. The Request for Proposal for BuyBoard Cooperative Purchasing RFP No. 608-
20 was submitted on November 7, 2019. BuyBoard contracts are competitively bid to increase and simplify the purchasing power of government
entities across the State of Texas.
A M/WBE goal is not assigned when purchasing from an approved purchasing cooperative or public entity.
This project will serve ALL COUNCIL DISTRICTS.
FISCAL INFORMATION / CERTIFICATION:
The Director of Finance certifies that funds are available in the current capital budget, as previously appropriated, in the General Capital Projects
Fund for the FY 2023 Paygo Traffic Signal project to support the approval of the above recommendation and execution of the contract. Prior to any
expenditure being incurred, the Transportation & Public Works Department has the responsibility to validate the availability of funds.
Submitted for City Manager's Office by. Reginald Zeno 8517
William Johnson 5806
Originating Business Unit Head: Reginald Zeno 8517
Lauren Prieur 6035
Additional Information Contact: Anthony Rousseau 8338
Alyssa Wilkerson 8357